Individual
ALIDA M. BLOOM
Active
Individual
ALIDA M. BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CS, FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
089317
MO
363LF0000X
Family Nurse Practitioner
Primary
089317
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12432
COX HEALTH PLANS UPI
MO
01
—
1602599
UNITED HEALTHCARE
MO
01
—
177827
ANTHEM BLUE CROSS/SHIELD
MO
05
—
502277007
—
MO
01
—
P01996
USPS (W/C)
MO
Enumeration date
05/30/2006
Last updated
06/02/2010
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